Care Home: Upper Lattimore Road (2)

Similar services:

• Coopers Mill Ltd
• Bramley Avenue (73)
• Paradise Lodge
• Grangewood
• Upaya Ananda
• Newton Court (1-2)
• Kings Lane (32)
• Pemdale

What the care home does well The EBE said, "I felt this home was one of the best I have seen. Residents said they liked the staff and were very helpful towards them." The Annual Quality Assurance Assessment (AQAA) states that there is a full care plan in place for service users to ensure best quality of life. A full induction and training programme for staff ensures that best service is delivered. A full quality assurance programme is in place and expanded throughout the year. There is good relationship between the staff and residents, and staff are aware of the residents` individual needs and preferences and enable them to make appropriate choices and decisions about their lives in the home. The ethos of the home is that it is the home of the residents, and the staff support them to be as independent as possible. All the residents spoken said that they are happy in their home. The staff spoken to said that they feel well supported by the company and the management. What has improved since the last inspection? All the requirements from the last inspection report have been met. The care plans have improved, and they are regularly reviewed and updated. There are very good procedures in place for monitoring medication, to make sure that it is administered and recorded properly. The health and safety records provide evidence that the safety of everyone in the home is protected. CARE HOME ADULTS 18-65 Upper Lattimore Road (2) Kyros House 2 Upper Lattimore Road St Albans Hertfordshire AL1 3TU Lead Inspector Claire Farrier Unannounced Inspection 8th November 2007 3:20 Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Upper Lattimore Road (2) Address Kyros House 2 Upper Lattimore Road St Albans Hertfordshire AL1 3TU 01727 858 783 01727 858 783 kyroshse@walsingham.com www.walsingham.com Walsingham Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Jose Arlindo Vasconcelos Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th November 2006 Brief Description of the Service: Kyros House at 2 Upper Lattimore Road is a care home providing personal care and accommodation for six people who have a learning disability. It is operated by Walsingham, which is a voluntary organisation. The home is situated close to local shops and the main town of St Albans is a short car journey away. It is a two storey detached house, providing six single bedrooms for the residents. None of the bedrooms have en-suite facilities. The house provides a domestic environment and it is indistinguishable from the neighbouring houses. Information on the fees charged was not available on this occasion. The Statement of Purpose and Service Users’ Guide provide information about the services provided by the home for prospective residents and social workers. For a copy of these documents, a copy of the most recent CSCI inspection report and details of the fees please contact the manager. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We spent one afternoon at 2 Upper Lattimore Road, and the people who live there and work there did not know that we were coming. The focus of the inspection was to assess all the key standards. Some additional standards were also assessed. An Expert by Experience (EBE) took part in the inspection. The EBE is a person who has a learning disability, a support worker from Barking and Dagenham Mencap, who took notes and supported him. The EBE met and talked to all the people who live in the home. We also talked to some of the staff, and to the home’s manager. The manager sent some information (the Annual Quality Assurance Assessment, or AQAA) about the home to CSCI before the inspection, and his assessment of what the service does in each area. Evidence from the AQAA has been included in this report. What the service does well: What has improved since the last inspection? All the requirements from the last inspection report have been met. The care plans have improved, and they are regularly reviewed and updated. There are very good procedures in place for monitoring medication, to make sure that it is administered and recorded properly. The health and safety records provide evidence that the safety of everyone in the home is protected. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sufficient information on residents’ needs and access to appropriate services to enable their needs to be met. EVIDENCE: The people who live in the home are aged between 47 and 83. No one has moved into the home for several years. Walsingham has a process for assessment before anyone moves into a home, and care plans are written with information and procedures drawn from these assessments. During this inspection the staff said that they have sufficient information and training to enable them to meet the residents’ needs. The Expert by Experience (EBE) noticed that staff were always on hand to help assist the residents, and the people he spoke to said that said they liked the staff and the staff were very helpful towards them. The Annual Quality Assurance Assessment (AQAA) stated: “We as organization feel that we have policies and procedures in place to ensure we meet the requirements and standards but are always willing to change by keeping up with legislation etc.” Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some care plans contain insufficient information on each person’s personal care and health care needs to enable verification that staff know what or how care is to be provided to meet peoples needs. The people who live in the home say that they feel involved in decision making in the home. EVIDENCE: We looked at the files of three people, which show what care is provided for them and how it is recorded. The care plans are written in a person centred format, which shows that people are involved in making decisions about their care and their lives in the home. The files include a personal planning book. Entries are written in the first person and describe the person’s personal preferences, how they make decisions, and the support that they need. The Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 10 staff who we spoke to said that the care plans provide them with good information on each person’s needs, so that they are able to provide a good quality of care in the way that each person wishes. One care plan was very well written, with full details of the support that the person needs in all aspects of their life. However some care plans do not provide clear details of the support and assistance that each person needs. One person has poor mobility. They walk with the aid of a Zimmer frame indoors, and use a wheelchair outside. This person also has epilepsy. There is no care plan for either mobility or for epilepsy. The staff are experienced and know the needs of each person well, but the information on these needs is not recorded effectively. Each person has risk assessments for some activities where a decision has been made concerning their safety. In some files it is not clear which risk assessments are current and which no longer apply. The purpose of risk assessments is to ensure that the people who live in the home can take part in the activities that they wish to. Some risk assessments do not provide a clear assessment of what the risks are, and the measures that have been agreed to manage the risks. One risk assessment for a person who looks after some of their own medication does not give details of which medication they look after and which the staff administer. A risk assessment for a person who may get annoyed with other service users and show their frustrations does not have clear details of when and how staff should intervene, and there is no reference to behaviour guidelines. One person smokes, and the risk assessment states that the cigarettes are limited to two in the morning and one in the evening. There is no reason for this limit, or agreement to the limit. However a record is kept of the cigarettes that are given to this person, and it shows that when additional cigarettes are requested they are not refused. The Expert by Experience (EBE) spoke to most of the people who live in the home, and asked them about the decisions that they make every day. They told him that the staff hold meetings every month, and they can have another meeting if they need to in between the monthly meetings. All residents can discuss all that they want at these meetings. They can help choose what they want in the home and they choose what they want in their bedrooms. The staff told the EBE that they look after the residents’ money and give some money to the residents to purchase what they want. The residents said that they can have their own money, and they are able to buy what they like with their money. One person bought a fish tank and some fishes out of her own money. The people who spoke to the EBE said that they get on well with all the staff. They are able to wear their own clothes and pick their own clothes for the day. They have their own front door key. One person keeps their key in her handbag. Self-advocacy is promoted by the home, and advocacy is available when needed from the advocacy group POhWER. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are supported to live full and active lifestyles. EVIDENCE: The staff support and encourage the people who live in the home to develop and maintain their independence. Each person has a weekly programme of meaningful activities, and everyone attending day centres or clubs in the local community during weekdays. The residents are full members of the community, and they use local amenities and facilities with support as necessary, including local shops, pubs, clubs, cinema, and public transport. They also access community health services such as GPs, dentists, opticians, chiropodists and so on. The Expert by Experience (EBE) spoke to most of the people who live in the home, and asked them about the things they do during the week and at Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 12 weekends. One person said that they enjoyed going to college. Two people spoke about the day care they had been to during the day, and one person said they went shopping with a key worker to get their Christmas shopping. They can all watch TV as and when they like. On bonfire night a few days before this inspection some people watched fireworks from the windows. They were able to go outside if they wished. One person said they were scared of the firework noise and wanted to stay inside with the staff. Some people said that their families visit the home to see them. The Annual Quality Assurance Assessment (AQAA) stated that one thing that the home does well is to maintain regular contact with families. People told the EBE that they can choose what they have to eat. They can make their own breakfast. However he noticed that the residents were not allowed to go into the kitchen and make their own lunch or dinner. He reported: ”Staff do the cooking, residents do not cook food or make any sandwiches for their self. I do not see why the residents who can make their own lunch are not allowed to have this choice.” When we asked the staff, they said that no one wants to be involved in cooking meals, and some would find it difficult. The staff told the EBE that they do most of the chores. Some people said they make their own beds if they choose to. Everyone sorts their own laundry; ands puts their clothes away when they have been washed. The EBE was told that the manager does the garden and residents do not get involved. This is their choice; the residents could help more in the garden if they wanted to. The AQAA stated that one thing that could be done better is to promote better independence. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are confident that they will receive a good quality of personal care and healthcare. EVIDENCE: Most of the residents look after their own personal care, and the care plans contain good details of the care needs of those that need some assistance. The healthcare records seen included references to hospital visits, and contact with GPs and other health professionals. Some of the older residents have health problems associated with increasing age, and the staff spoken to showed good understanding of each resident’s personal and healthcare needs. Behaviour guidelines are in place for one person. Another person is epileptic, and the staff showed good understanding of the support that they need. The people who spoke to the Expert by Experience (EBE) said that they liked the staff, and the staff were very helpful towards them. One person, who chooses to smoke, smokes outside in a chair that they have in the shed. The EBE noticed that the staff encouraged this person to give up smoking and gave them a choice of aids to quit. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 14 The home has sound systems in place for the safe management of medication. The residents who are able to do so look after and administer their own medication. Storage is secure in the office and administration records checked were error-free, with no signature gaps found on the MAR (medication administration record) charts. The medication and records are checked every day to make sure that all the medication has been administered properly. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and enabled to make their views and concerns known. Policies and procedures are in place to ensure that service users are protected from abuse and neglect. EVIDENCE: The ethos of the home is to empower the residents to express their opinions, including concerns and complaints about the service provided. In support of this ideal the home has a satisfactory complaints procedure in place that is available to all residents and their relatives. No complaints have been recorded since the last inspection. There are up to date policies concerning safeguarding adults that follow the Hertfordshire inter-agency guidelines and a copy of the guidelines is kept in the office. All staff have had training in the prevention of abuse. Staff spoken with were aware of the general principles involved including the company’s whistle-blowing policy. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a safe and comfortable environment for the people who live there. EVIDENCE: The building is an ordinary detached house, furnished and decorated in domestic styles that produce a homely, comfortable environment, which allows the people who live there to relax and feel very much at home. Everyone has their own room, which is arranged and decorated to reflect their particular interests and tastes. The lounge, dining room and kitchen are domestic in style and are comfortably furnished and well equipped. The Expert by Experience (EBE) reported: “One resident showed me their bedroom, the rooms are not very big, but had a window overlooking the front of the home. The resident had photos in the bedroom of family. They had a little portable TV. Resident said they like their bedroom.” Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 17 There is a rolling programme of refurbishment and redecoration. The kitchen is due for refurbishment this month, and the carpets in four bedrooms were due to be replaced in the week after this inspection. There is a new shed in the garden, which is used as a smoking area. The home appeared to be clean and generally well maintained, and the staff follow appropriate procedures to maintain hygiene and prevent the risk of infection. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A stable staff team, who have the experience and training to understand and meet the residents needs, supports the people who live in the home. EVIDENCE: The people who spoke to the Expert by Experience (EBE) said that the staff were very nice. They were always available to talk with the residents and seemed happy to help. He spoke to some of the staff, who told him that they were all happy working in the home and were always talking to the residents. There are two support workers on duty throughout the day from 8 am to 9 pm, and one support worker sleeps in at night. These levels are adequate to meet the needs of the current group of residents. The member of staff who sleeps over during the night frequently works a total of up to 19 hours without a break, from 2pm to 11pm, followed by the sleepover, then from 6am to 11am. This schedule does not comply with the Working Time Regulations, but the support workers who we spoke to said that they like this pattern of working as they have more time off. One person said that no-one has left the Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 19 home during the last three years, and the management and staff team support each other well. Agency staff are used occasionally. Walsingham provides comprehensive training for staff that covers all mandatory training in first aid, moving and handling, fire safety, food hygiene, etc, and training to meet special needs the residents have such as bereavement and challenging behaviour. The staff spoken to said that the training and support provided for them is very good. 2 of the 8 support workers have a qualification at NVQ2 or above, and 4 are working towards it. The manager confirmed that the recruitment procedures followed by the company are robust and that he sees all the information on each applicant during the recruitment process. The references, CRB (Criminal Record Bureau) disclosures, evidence of identity and full employment history are stored at Walsingham headquarters, and a record sheet in each person’s file confirms that these are satisfactory. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed for the benefit of the people who live there. EVIDENCE: The home is well run in accordance with the principles set out in the Statement of Purpose. The manager is experienced in social care and is taking the Registered Manager’s Award course. The manager sets the tone for the home, provides strong leadership to the team and enjoys good relationships with the residents. The Expert by Experience (EBE) said, “I saw the manager of the home towards the end of my visit. He said “Hello”. He seemed to be friendly.” Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 21 Walsingham has a comprehensive system for quality assurance in its homes, which includes annual surveys of residents and their families. The company carries out regular service audits of the home and monthly Regulation 26 monitoring visits, and reports of the visits are sent to CSCI. There are regular residents’ meetings on the home, and several issues raised by the residents have been acted on. These include a shed in the garden and redecoration. Appropriate records are maintained for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. All the staff have training in moving and handling, fire safety, food hygiene and infection control as part of their induction. Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(1) Requirement All care plans must provide adequate and appropriate details of each person’s needs, so that the staff have the information that they need to be able to support them appropriately. Appropriate and adequate risk assessments must be put in place for all residents for situations in which there is any risk of harm or injury to themselves or others. Timescale for action 08/02/08 2. YA9 13(4) 08/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Upper Lattimore Road (2) DS0000019599.V355368.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!